Abstract
IntroductionThis study aims to determine the Acinetobacter sp clinical isolates frequency and its antibiotic susceptibility pattern by comparing results obtained from the Intensive Care Units (ICUs) to that of other units at the Mohammed V Military Teaching Hospital in Rabat.MethodsThis is a retrospective study over a 2-years period where we collected all clinical isolates of Acinetobacter sp obtained from samples for infection diagnosis performed on hospitalized patients between 2012 to 2014.ResultsDuring the study period, 441 clinical and non-repetitive isolates of Acinetobacter sp were collected representing 6.94% of all bacterial clinical isolates (n = 6352) and 9.6% of Gram negative rods (n = 4569). More than a half of the isolates were from the ICUs and were obtained from 293 infected patients of which 65, 2% (191 cases) were males (sex ratio = 1.9) and the median age was 56 years (interquartile range: 42-68 years). Acinetobacter clinical isolates were obtained from respiratory samples (44.67%) followed by blood cultures (14.51%). The resistance to ciprofloxacin, ceftazidime, piperacillin / tazobactam, imipenem, amikacin, tobramycin, netilmicin, rifampicin and colistin was respectively 87%, 86%, 79%, 76%; 52%, 43%, 33% 32% and 1.7%. The difference in resistance between the ICUs and the other units was statistically significant (p <0.05) except for colistin, tetracycline and rifampicin.ConclusionThis paper shows that solving the problem of prevalence and high rate of multidrug resistant Acinetobacter infection which represents a therapeutic impasse, requires the control of the hospital environment and optimizing hands hygiene and antibiotics use in the hospital.
Highlights
This study aims to determine the Acinetobacter sp clinical isolates frequency and its antibiotic susceptibility pattern by comparing results obtained from the Intensive Care Units (ICUs) to that of other units at the Mohammed V Military Teaching Hospital in Rabat
All isolates of Acinetobacter resistant to three or more classes of antibiotics represented by piperacillin / tazobactam, ceftazidime, imipenem, ciprofloxacin, aminoglycosides and colistin were considered as Multidrug resistant (MDR) [18, 21, 23]
The current study demonstrated that the percentage of MDR Acinetobacter was 77.4% throughout the hospital and extents 92.6% in ICUs and 75.3% in the other units with a rate difference that was statistically significant between the ICUs and the other units (p
Summary
This study aims to determine the Acinetobacter sp clinical isolates frequency and its antibiotic susceptibility pattern by comparing results obtained from the Intensive Care Units (ICUs) to that of other units at the Mohammed V Military Teaching Hospital in Rabat. Methods: This is a retrospective study over a 2-years period where we collected all clinical isolates of Acinetobacter sp obtained from samples for infection diagnosis performed on hospitalized patients between 2012 to 2014. Acinetobacter is a non-fermenting Gram negative coccobacillus with a high capacity to colonize the human body and the environmental reservoirs [1] It has become over the past three decades a major associated care infections agent with a high morbidity and a high mortality rate especially in immunocompromised patients ranging from 26.5 to 91% [2,3,4,5]. In Morocco, a retrospective study [6] from 2002 to 2005 showed that this bacterium represented 13.63% of clinical isolates from blood cultures in the intensive care units (ICUs). Acinetobacter is an opportunistic pathogen known for its intrinsic resistance to antibiotics and greater ability to rapidly acquire resistance genes as mobile genetic elements (plasmids, transposons, integrons cassettes and insertion sequences) [11,12,13]
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